Cornelia de Lange Syndrome

Cornelia de Lange Syndrome
Classification and external resources
ICD-10	Q87.1 (ILDS Q87.170)
ICD-9	759.89
OMIM	122470
DiseasesDB	29651
eMedicine	ped/482
MeSH	C10.597.606.643.210

Cornelia de Lange Syndrome (CdLS) often termed as Bushy Syndrome is a genetic disorder that can lead to severe developmental anomalies. It affects the physical and intellectual development of a child. Exact incidence is unknown, but it is estimated at 1 in 10,000 to 30,000.^[1]

! Appx. % ! Notes |- | CDLS1 | 122470 | NIPBL | 50% | A gene responsible for CdLS on Chromosome 5 was discovered in 2004 jointly by researchers at the Children’s Hospital of Philadelphia, USA^[2] and researchers at Newcastle University, UK.^[3] |- | CDLS2 | 300590 | SMC1A | 5% | In 2006, a second gene, on the X chromosome, was found by Italian scientists. |- | CDLS3 | 610759 | SMC3 | 1% | A third gene discovery was announced in 2007. The gene is on chromosome 10 and was also discovered by the research team in Philadelphia. |}

The latter two genes seem to correlate with a milder form of the syndrome.

Evidence of a linkage at chromosome 3q26.3 is mixed.^[4]

History

The first ever documented case was in 1916 by W. Brachmann^[5] followed up by Cornelia de Lange,^[6] a Dutch pediatrician, in 1933 after whom the disorder has been named.^[7]

Diagnosis

The diagnosis of CdLS is primarily a clinical one based on signs and symptoms (see below) observed through an evaluation by a physician, including a medical history, physical examination, and laboratory tests. Since 2006, testing for NIPBL and SMC1A has been available through the University of Chicago.[1] This is best accomplished through a referral to a genetics specialist or clinic.

CdLS is thought to be underdiagnosed and frequently misdiagnosed.^{[citation needed]}

Children with this syndrome are often found to have long eyelashes, bushy eyebrows and synophrys (joined eyebrows). Body hair can be excessive and affected individuals are often shorter than their immediate family members.

CdLS can give rise to its own array of complexities. Children with CdLS often suffer from gastrointestinal tract difficulties, particularly gastroesophageal reflux. Vomiting, intermittent poor appetite, constipation, diarrhea or gaseous distention are known to be a regularity in cases where the GE tract problems are acute. Symptoms may range from mild to severe.

CdLS may include behavior problems, including self-stimulation, aggression, self-injury or strong preference to a structured routine. Many children with CdLS exhibit autistic-like behaviors.

Behavior problems in CdLS are not inevitable. Many behavior issues associated with CdLS are reactive (i.e., something happens within the person's body or environment to bring on the behavior) and cyclical (comes and goes). Often, an underlying medical issue causes a change in behavior. Once the medical issue is treated, the behavior diminishes.

Treatment

Often, an interdisciplinary approach to therapy and treatment of any medical issues that arise is recommended. A team for promotion of the child's well being often includes speech, occupational and physical therapists, teachers, physicians and, most importantly, the parent(s). Treatment protocols can be viewed at http://www.cdlsusa.org/treatment_protocols.shtml.

Support

The Cornelia de Lange Syndrome (CdLS) Foundation is a nonprofit, family support organization based in Connecticut which provides materials for public education and information. In addition to Reaching Out, a bi-monthly newsletter, the foundation produces and distributes other publications on the syndrome, as well as a free video [2].

References

1. ^ "Bushy Syndrome- Genetics Home Reference". http://ghr.nlm.nih.gov/condition=corneliadelangesyndrome. Retrieved 2007-08-24. 
2. ^ Krantz ID, McCallum J, DeScipio C, et al. (2004). "Cornelia de Lange syndrome is caused by mutations in NIPBL, the human homolog of Drosophila melanogaster Nipped-B". Nature Genetics 36 (6): 631–5. doi:10.1038/ng1364. PMID 15146186. 
3. ^ Tonkin E, Wang TJ, Lisgo S, Bamshad MJ, Strachan T (2004). "NIPBL, encoding a homolog of fungal Scc2-type sister chromatid cohesion proteins and fly Nipped-B, is mutated in Cornelia de Lange syndrome". Nature Genetics 36 (6): 636–641. doi:10.1038/ng1363. PMID 15146185. 
4. ^ Krantz ID, Tonkin E, Smith M, et al. (June 2001). "Exclusion of linkage to the CDL1 gene region on chromosome 3q26.3 in some familial cases of Cornelia de Lange syndrome". American Journal of Medical Genetics 101 (2): 120–9. doi:10.1002/1096-8628(20010615)101:2<120::AID-AJMG1319>3.0.CO;2-G. PMID 11391654. 
5. ^ Brachmann, W. Ein Fall von symmetrischer Monodaktylie durch Ulnadefekt, mit symmetrischer Flughautbildung in den Ellenbeugen, sowie anderen Abnormitaeten (Zwerghaftigkeit, Halsrippen, Behaarung) (A case of symmetrical monodactyly, representing ulnar deficiency, with symmetrical antecubital webbing and other abnormalities, (dwarfism, cervical ribs, hirsutism)). Jahrbuch fuer Kinderheilkunde und physische Erziehung 84: 225-235, 1916.
6. ^ de Lange, C. Sur un type nouveau de degenerescence (typus Amstelodamensis). Arch. Med. Enfants 36: 713-719, 1933.
7. ^ http://www.whonamedit.com/synd.cfm/1080.html

External links

• Cornelia de Lange Syndrome Foundation, Inc.
• Development of Diagnostics and Therapeutics for Cornelia de Lange Syndrome
• Genetic Alliance
• Cleft and Craniofacial Anomalies
• Pediatric Database (PEDBASE)
• GeneReviews/NCBI/UW/NIH entry on Cornelia de Lange syndrome
• Leiden Open Variation Database for Cornelia de Lange Syndrome